| NPI | 1750576278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD LELAND TORGESON Owner 801-262-1181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 6492935-9922) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2012-01-13 |